Vukovich Insurance
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Aimee Vukovich
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Home Insurance: Please provide the following information and we will get back to you with a premium indication, or call you if any additional questions:
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Indicates required field
Name
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First
Last
Email
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Daytime phone number at which we can reach you
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Is this your primary residence?
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Any business conducted on the premises?
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Property Address
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Your age or birth date
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Any claims or unpaid losses?
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How many years have you had uninterrupted insurance?
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Current homeowner insurer (if none, please indicate, none)
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Is property deeded in your name? If no, please elaborate
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Year of Construction?
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Construction Type: (i.e., site built, manufactured home, etc)
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Style of home (i.e. log home, dome, custom, ranch, contemporary)
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Protective Devices (i.e. smoke alarm, central station alarm, gated community)
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Distance to nearest fire hydrant?
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Roof Type? (Comp Shingle, flat with tar/gravel, shake, tile, cement)
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Age of roof
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Primary heat source (i.e., heat pump, central, space, wood stove)
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Amount of coverage on the home you desire a quote for (this is subject to change, based on replacement cost guidelines set forth by the company)
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Any specific items for which you desire coverage (including jewelry, numismatic property, fine arts, collectibles)
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Requested Liability Limits
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$100,000 (included)
$300,000
$500,000
$1,000,000
Any animals? if so, please list type/breed and number
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Trampoline or Swimming Pool?
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Desired Property Deductible?
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$250
$500
$1,000
Other, please specify in your remarks at the end of this questionnaiare
Do you own any other residences? If yes, please provide use (i.e. vacation home, rental)
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Please include any additional information or comments here, including if you've had any cancellations or non renewals. Details on any claims you may have had past 5 years
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Submit